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new exam 2 Flashcards

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1
Q

what defines preterm

A

after 20 weeks and before 37 weeks

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2
Q

biggest risk factor for preterm birth is

A

prior pre term labor

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3
Q

preterm labor criteria

A

UC >6 an hour AND ROM or cervical changes

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4
Q

what does a negative fetal fibronectin mean

A

woman will not deliver within 7-14 days

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5
Q

goal of preterm labor

A

delay birth until corticosteroids (betamethasone) have 72 hours or more to develop fetal lungs

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6
Q

role of magnesium sulfate

A

smooth muscle relaxant

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7
Q

5 risks factors of women to get gestational diabetes

A

women over age 35,
obesity,
family history,
non-Caucasian,
personal hx of gestational diabetes

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8
Q

screening and diagnosing gest. diabetes

A

1hr GTT - if <135 needs 3 hr
3 hr GTT - 2 or more abnormal values means Diagnosed

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9
Q

treating gestational diabetes

A

diet and exercise glycemic control

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10
Q

when does need for insulin increase in preg

A

2nd or 3rd tri

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11
Q

HTN is defined as

A

140/90

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12
Q

chornic HTN defined as

A

preexisiting before 20 weeks

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13
Q

gest HTN defined as

A

after 20 weeks NO proteinuria

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14
Q

preelcampsia defined as

A

systemic disease with HTN and PROTEINURIA AND EDEMA after 20 weeks

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15
Q

eclampsia defined as

A

convulsive state of preelcmapsia

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16
Q

what to give when eclampsia and what to monitor

A

Mg sulfate - RR and DTR

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17
Q

4 risk factors for preeclampsia

A

Primigravida

Hx of personal or
family member
with pre-eclampsia

Paternal Hx (partner previously fathered a pre-eclamptic pregnancy in another woman)

Multiple gestation

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18
Q

6 s.s of preelcampsia

A

Headache
Visual changes
Proteinuria (1+ or greater)
Nausea
Epigastric pain or upper right quadrant pain
Edema (quick onset- face/hands/feet)

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19
Q

labs with preelclampsia

A

Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP)
+ elevated BUN, Cr, uric acid

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20
Q

placenta previa vs placental abruption

A

previa: painless bright red bleeding

tx: C section, NO VAGINAL EXAMS

abruption: SEVERE pain, dark red bleeding, shock (this means lots of blood loss)

tx: energent C section, NO VAGINAL EXAMS

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21
Q

hyperemesis gravidarum tx 5

A

replace f/e with fluids, antiemetics,
accupressure,
ginger/mint,
emotional support

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22
Q

what is ectopic pregnancy

A

implantation into ampulla of fallopian tube

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23
Q

ectopic preg teaching

A

avoid preg for 3 months

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24
Q

teaching for gestational trophoblastic disease

A

avoid pregnancy for 1 year

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25
tx of incompetent cervix
ultrasound to monitor for cervical length and cerclage
26
major risk of ROM
chorioemnionitis
27
heart disease and preg connection
sometimes heart disease isnt diagnosed until preg due to cardiac adaptations
28
7 fetal complications of multiple gestations
Premature birth Lower Birth Weight IUGR and discordant growth placental abnormalities HTN disorders gest DM anemia
29
7 ss of iron def anemia
fatigue weakness malaise pallor tachycardiac infection risk preterm labor risk
30
3 tx for management of iron def anemia
vitamin C stool softeners /fiber high iron foods
31
if somone with anemia has leg pain why is it most concernign
bc of vasoocclusive crisis
32
worse complications of sickle cell crisis
leg pain/red calf and inflammed
33
2 teaching for HIV
can still have a vaginal birth no breastfeeding
34
what if someone with HIV says they have to have a c section
its not true
35
what if mom has rubella or varicells
vaccinate after birth
36
what if mom has herpes
need c section if active infection
37
what to do if mom has hep B
newborns recieve HBV and HPV vaccine
38
parovirus education
transmitted in daycare settings
39
complications of gonorrhe
opthalmia - blindness
40
what if mom has group B strep
antibiotics during labor
41
3 results of substance abuse in preg
preterm placental issues vasoconstriction
42
what stimulates labor
oxytocin stimulates contraction of smooth muscle
43
5 risks of preterm birth
lung immaturity (and resulting respiratory complications), difficulties with temperature and blood sugar regulation, decreased resistance to infection, other immature organ systems, intracranial bleeding.
44
3 risks of postdates birth
placenta insufficiency (decreased oxygen to baby, decrease amniotic fluid), fetal “wasting”, fetal death
45
duration and normal
start of contraction to end 45-60 seconds
46
frequency and normal
Timed from the beginning of one to the beginning of the next. “q3-4min”
47
what does station 0 mean
midpelvis at ischial spine - narrowest diameter
48
what is station
Relationship of ischial spines to presenting part of fetus
49
what is estrogen and relaxin role
soften cartilage in pelvic joints and increase elasticity of ligaments
50
fetal attitude
Relationship of fetal body parts to one another
51
fetal lie + ideal
Relation of the mother’s spine to the fetus’s spine + longitudinal
52
what position should baby be in
anterior occipit
53
semirecumbent advantage
Reduce likelihood of supine hypotension
54
lateral position advantage
Removes pressure from the back
55
what position to get in if fetus is posterior
hands and knees
56
5 ss of impending labor
lightening braxton hicks cervical ripening nesting bloody show
57
6 features of real labor
Occur at regular intervals Increase in frequency over time Become stronger over time Cause the cervix to dilate Do not stop with change in activity “5-1-1” Rule (every 5 minutes, lasting 60 seconds, and have been this way for 1 hour)
58
2 assessments for ROM
fetal HR and meconium (color, amt, odor)
59
1st stage of labor - latent phase length
1-24 hours / 0-3cm
60
active phase of 1st stage of labor
3-7cm / 1-12 hours
61
transition phase 1st stage of labor
1-3 hours / 7-10cm
62
when should monitoring increase in labor
2nd stage
63
nursing actions in 1st stage of labor 3
hydration void every 2 hours assess HR
64
how long should active phase of 2nd stage of labor last
5min to 3 hours
65
time of rest between contractions
every 2-3 minutes lasting 60-90 seconds
66
what is important in 3rd stage of labor
placental assessment
67
12 non pharm labor discomfort actions
Childbirth preparation Relaxation and breathing techniques Massage and effleurage, counter-pressure Heat & cold Hydrotherapy Acupressure Attention focusing and imagery Ambulation and position changes Continuous labor support TENS unit Sterile water papules (intradermal water block) Music
68
what to avoid within 1st hour of birth
opioids
69
when is epidural given
when labor is establushed - during 1st stage in active phase
70
5 actions for epidural
fluid bolus VS of mom and fetus q 5 min for 15 change positions often urinary retention (may need cath) monitor for hypotension
71
how to assess strength of uterine contraction
IUPC
72
category 1 FHR
Baseline HR: 130 Variability: Moderate Decelerations: Early (no late or variable) Accelerations: 1-2 lasting <2 minutes
73
normal uterine activity
every 3-5 min
74
tx for cord compression
change positions
75
tx for cord prolapse
lift up on cord until baby is out
76
4 actions for fetal distress
reposition O2 fluids decrease ptosin
77
IUPC measures
uterine contraction frequency, duration and intensity
78
what is fetal acceleration
Peak of the acceleration is >15 bpm over the baseline FHR for > 15 sec and < 2 min
79
VEAL CHOP
80
what is most common reason for cbirth
dystocia
81
hyper vs hypotonic uterine dysfunction
Hypertonic uterine dysfunction – frequent and painful UC’s yet uncoordinated with little cervical change and inadequate uterine relaxation Hypotonic uterine dysfunction - strength of UC is too weak and is insufficient to promote cervical effacement or dilation
82
Fetus moves through the maternal pelvis best
with head down and flexed in the occiput anterior position
83
CPD what is it and what to do
size, shape, or position of the fetal head prevents passage through maternal pelvis. prepare for c section
84
primary complication of oxytocin induction
uterine tachysystole “hyperstimulation” - >5 UC’s in 10 minutes
85
nursing action for hyperstimulation UC caused by induction
assess HR and then dec oxytocin
86
4 maternal risks of postterm and when is postterm
after 42 weeks Dystocia of labor Birth trauma Postpartum hemorrhage Potential infection
87
2 contraindication for VBAC/TOLAC
no inductions if more than 1 c section previous = no VBAC
88
what to do if shoulder dystocia
mcroberts
89
4 issues of c births
increased time in hospital, longer physical recovery, increased pain, emotional issues
90
What is the difference between preeclampsia and gestational hypertension?
Pre-eclampsia is a systemic disease causing proteinuria
91
what is placenta acreta
when placenta is retained and heavy bleeding
92
4 times vaginal birth cant happen
active herpes placenta previa breech prolapsed cord
93
3 things to monitor with FHR
Baseline HR Baseline Variability Periodic/Episodic Baseline changes
94
when is emotional support most important in labor
transition of stage 1
95
biggest risk for VBAC
uterine rupture

OB (5 decks)

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